For ACA, must get insurance in U.S.

Can I get health insurance from a foreign country? I was just wondering: could it be cheaper to get a German, Canadian or whatever private health insurance, that pays for my everyday health checks as well as possible serious procedures?

Will Travel

Dear Will Travel,

It may be cheaper to buy prescription drugs from other countries, but you can’t import health insurance. There are not insurers in Germany or Canada offering policies to Americans living in the United States. They probably won’t start any time soon either. In order to meet your obligation to have health insurance, the policy has to meet many different standards. One of the standards is having enough “in network” hospitals and doctors; a foreign insurer would not have this. Nor would they be able to meet all of the other requirements of the Affordable Care Act.

If you lived in a foreign country, you can have that country’s insurance plans and you wouldn’t be considered uninsured by the Affordable Care Act. (Actually, you can have no insurance while you are living abroad and still face no penalty.) As soon as you get back to the U.S., you have to get U.S. health insurance or pay the tax penalty assuming that you are required to have health insurance.

There are plenty of exceptions to the rule requiring people to have health insurance. (See the list of exemptions.) If you do have to have insurance, you may qualify for subsidies. Short of that, you can always pay the penalty and stay uninsured.